De bedwants: a bad bug?

Abstract

The bed bug: a bad bug? The common bed bug, Cimex lectularius, is a bloodsucking ectoparasite which attacks mammals and is on the rise since the beginning of the early 21st century. They are brown and flat. Skin lesions appear after the painless bite, often during the predawn hours. Small, purpuric macules develop into erythematous, indurated papules on exposed areas of skin of the face, neck and extremities, and resolve over the course of 2 weeks. Often, a linear or cluster configuration of 3 to 4 lesions (‘breakfast, lunch and dinner’) appears. Pruritic wheal reactions represent a type 1 hypersensitivity reaction elicited by the parasite’s saliva antigens. The clinical differential diagnosis is broad and may include other insect and arthropod bites and stings, scabies infestation, dermatitis herpetiformis, ecthyma, etc. There is no evidence that bed bugs are vectors and transmit human pathogens. They are responsible for considerable physical irritation and significant psychological distress. Very rarely, the patient could develop anemia or anaphylaxis. Control involves treating both the patient’s symptoms and the cause by the eradication of the infestation, a challenge that may require a professional exterminator for an integrated pest management strategy. “Good night, sleep tight, don’t let the bed bugs bite!”